Felis ISSN 2398-2950

Pancreatitis

Contributor(s): Julien Bazelle, Philip K Nicholls, Kenneth Simpson

Introduction

  • Signs: often vague (lethargy, anorexia); or asymptomatic.
  • Diagnosis: elevated feline pancreatic lipase, ultrasonography, histopathology.
  • Treatment: intravenous fluid support, dietary modification, enteral/parenteral nutrition, pain relief, anti-nauseous medications.
  • Prognosis: variable.
    Print off the owner factsheet onPancreatitis  Pancreatitis  to give to your client.Follow the diagnostic tree for Vomiting/anorexia in suspected pancreatitis  Vomiting

Pathogenesis

Etiology

Predisposing factors

General

  • Hyperstimulation of pancreas.
  • Blocked pancreatic ducts.

Pathophysiology

  • Hyperstimulation of pancreas or blocked pancreatic duct   →   fusion of zymogen granules and lysozymes   →   activation of intrapancreatic trypsin and pancreatic autodigestion.
  • Oxygen-derived free radicals   →   damage to cell membranes   →   increased capillary permeability   →   edema.
  • Increased levels of proteases and phospholipase in pancreas and blood stream   →   necrosis   →   multisystem involvement including pulmonary edema and vasculitis. Trypsin activates coagulation cascade and fibrinolytic system can   →   disseminated intravascular coagulation.
  • Serum antiproteases and alpha-2 macroglobulin bind trypsin and are removed from circulation. Manifestations of pancreatitis are only seen when compensatory mechanisms are overwhelmed.
  • Pancreatitis is often found concurrently with other diseases, such as cholangiohepatitis Liver: cholangitis, and inflammatory bowel disease Inflammatory bowel disease: overview. The concurrent occurrence of these three disorders in cats is termed "triaditis".

Timecourse

  • Acute progression: 24-48 hours, but many cats appear to have chronic relapsing pancreatitis.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Marolf A J, Kraft S L, Dunphy T R et al (2013) Magnetic resonance (MR) imaging and MR cholangiopancreatography findings in cats with cholangitis and pancreatitis. J Feline Med Surg 15 (4), 285-294 PubMed.
  • Oppliger S, Hartnack S, Riond B et al (2013) Agreement of the serum Spec fPL" and 1,2 -omega-dilauryl-rac-glycero-3-glutaric acid-(5'-methylresorufin) ester lipase assay for the determination of serum lipase in cats with suspicion of pancreatitis. JVIM 27 (5), 1077-1082 PubMed.
  • Boscan P, Monnet E, Mama K et al (2011) Effect of maropitant, a neurokinin 1 receptor antagonist, on anesthetic requirements during noxious visceral stimulation of the ovary in dogs. Am J Vet Res 72 (12), 1576-1579 PubMed.
  • Giorano T, Steagall P V, Ferreira T H et al (2010) Postoperative analgesic effects of intravenous, intramuscular, subcutaneous or oral transmucosal buprenorphine administered to cats undergoing ovariohysterectomy. Vet Anaesth Analg 37 (4), 357-366 PubMed.
  • Trepanier L (2010) Acute vomiting in cats: rational treatment selection. J Feline Med Surg 12 (3), 225-230 PubMed.
  • Chan D L (2009) The inappetent hospitalized cat: clinical approach to maximising nutritional support. J Feline Med Surg 11 (11), 925-933 PubMed.
  • Schweighauser A, Gaschen F, Steiner J et al (2009) Evaluation of endosonography as a new diagnostic tool for feline pancreatitis. J Fel Med Surg 11 (6), 492-498 PubMed.
  • De Cock H E, Forman M A, Farver T B et al (2007) Prevalence and histopathologic characteristics of pancreatitis in cats. Vet Pathol 44 (1), 39-49 PubMed.
  • Forman M A, Marks S L, De Cock H E et al (2004) Evaluation of serum feline pancreatic lipase immunoreactivity and helical computed tomography versus conventional testing for the diagnosis of feline pancreatitis. JVIM 18 (6), 807-815 PubMed.
  • Steiner J M (2003) Diagnosis of pancreatitis. Vet Clin North Am Small Anim Pract 33 (5), 1181-1195 PubMed.
  • Simpson K W (2002) Feline pancreatitis. J Feline Med Surg (3), 183-184 PubMed.
  • Mansfield C S & Jones B R (2001) Review of feline pancreatitis part 1 - the normal feline pancreas, the pathophysiology, classification, prevalence and aetiologies of pancreatitis. J Feline Med Surg​ (3), 117-124 PubMed.
  • Mansfield C S & Jones B R (2001) Review of feline pancreatitis part 2 - clinical signs, diagnosis and treatment. J Feline Med Surg (3), 125-132 PubMed.
  • Gerhardt A, Steiner J M, Williams D A et al (2001) Comparison of the sensitivity of different diagnostic tests for pancreatitis in cats. JVIM 15 (4), 329-333 PubMed.
  • Simpson K W (2001) The emergence of feline pancreatitis. JVIM 15 (4), 327-328 PubMed.
  • Washabau R J (2001) Feline acute pancreatitis - important species differences. J Feline Med Surg (2), 95-98 PubMed.
  • Swift N C, Marks S L, MacLachlan N J et al (2000) Evaluation of serum feline trypsin-like immunoreactivity for the diagnosis of pancreatitis in cats. JAVMA 217 (1), 37-42 PubMed.
  • Zhao P, Tu J, Martens A et al (1998) Radiologic investigations and pathologic results of experimental chronic pancreatitis in cats. Acad Radiol (12), 850-856 PubMed.
  • Bruner J M, Steiner J M, Williams D A et al (1997) High feline trypsin-like immunoreactivity in a cat with pancreatitis and hepatic lipidosis. JAVMA 210 (12), 1757-1760 PubMed.
  • Steiner J M & Williams D A (1997) Feline pancreatitis. Cont Educ Pract Vet 19, 590-602.
  • Hines B L, Salisbury S K, Jakovljevic S et al (1996) Pancreatic pseudocyst associated with chronic-active necrotising pancreatitis in a cat. JAAHA 32 (2), 147-152 PubMed.
  • Weiss D J, Gagne J M & Armstrong P J (1996) Relationship between inflammatory hepatic disease and inflammatory bowel disease, pancreatitis and nephritis in cats. JAVMA 209 (6), 1114-1116 PubMed.
  • Akol K G, Washabau R J, Saunders H M et al (1993) Acute pancreatitis in cats with hepatic lipidosis. J Vet Intern Med (4), 205-209 PubMed.
  • Hill R C & Van Winkle T J (1992) Acute necrotising pancreatitis and acute suppurative pancreatitis in the cat; a retrospective study of 40 cases (1976-1989). JVIM (1), 25-33 PubMed.


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